马兜铃酸肾毒性的研究进展

Research progress of Aristolochic acid renal toxicity

马兜铃酸(AA)为硝基菲类有机酸类化合物,是马兜铃、关木通、细辛、广防己等植物的主要成分。马兜铃酸药理作用广泛,有抗感染、抗癌、增强细胞免疫及终止妊娠等功能。目前,含有马兜铃酸的中药或中成药广泛应用于风湿及泌尿系统等多种疾病,由于服用含有马兜铃酸成分的中药而引起的肾脏损害报道日益增加,马兜铃酸肾毒性作用越来越受到人们的重视。本文总结了近年来马兜铃酸化学结构、毒理作用基础及临床研究,并对其肾毒理作用机制进行综述,使其为临床合理应用含有马兜铃酸的中药或中成药制剂提供参考。通过设计安全有效的药用剂型,严格控制用药剂量和时间,避免长期或大剂量服用,预防并减少毒性作用,将使该药在临床上得到更广泛应用。

Aristolonic acid is a nitro phenanthrene organic acid compound found as a main compo- nent of Aristolochia, Guan mutong, Asarum, Aristolochia Fangchi and many other medicinal plants. Aris- tolochic acid is widely used in the pharmaceutical industry due to its anti infection, anti tumor, abortifa- cient and cellular immunity enhancing properties. Present uses of Aristolochic acid containing Chinese med- icine are for the treatment of rheumatic and urinary system diseases. However, there have been increased reports on kidney damage as a result of using Aristolochic acid containing drugs, which, leads to increased research in the field. It is necessary and crucial to provide proper reference for safer clinical use of Chinese traditional medicines with Aristolochic acid components. This paper therefore focuses on the structure, toxi- cological effects and clinical applications of Aristolochic acid as well as its renal toxicological mechanisms. We therefore conclude that, due to the beneficial medicinal properties of Aristolochic acid, it is necessary to design a safer and effective pharmaceutical dosage formulation and strictly control drug dose and time as well as duration of drug use in order to reduce its toxic effect, thereby increasing its clinical application.